Adding dendritic cell-immunotherapy for post-transplant hepatocellular carcinoma recurrence

Wei-Chen Lee^1*Chih-Hsien Cheng²Tsung-Han Wu²Yu -Chao Wang²Jin-Chiao Lee²Hao-Chien Hung²Chen-Fang Lee²Ting Jung Wu²Hong-Shiue Chou²Kun-Ming Chan²

• ¹College of Medicine, Chang Gung University, Taoyuan, Taiwan
• ²Linkou Chang Gung Memorial Hospital, Linkou, Taiwan

Background. Hepatocellular carcinoma (HCC) recurrence after liver transplantation is frequently multiple and extrahepatic, and with a poor prognosis. The therapeutic effects of current medications for post-transplant HCC recurrence are limited. This study assessed whether outcomes could be improved by adding dendritic cell (DC)immunotherapy to the treatment regimen.Methods. Eleven patients treated with tyrosine kinase inhibitors and DCimmunotherapy for post-transplant HCC recurrence between 2020 and 2024 were included. DC were propagated from peripheral blood monocytes and pulsed with tumor lysate. Historical data of patients (n =23) with tyrosine kinase inhibitors for posttransplant HCC recurrence between 2009 and 2020 were collected as a reference.Results. Seven male and four female patients were included in this study. The median (interquartile) tumor recurrence time after transplantation was 35.0 (7.4-55.3) months.The median number of DC-immunotherapy were 5 ranged from 3 to 10, and the median number of cells admitted was 29.5x10 6 cells ranged from 16.0 to 137.2 x10 6 cells.Responses to DC-immunotherapy included nine stable diseases and two progressive diseases. No adverse effects related to DC treatment were observed. The 1-, 2-and 3year survival rates were 70.7%, 40.4%, and 40.4%, respectively, compared to 52.5%, 17.4%, and 8.7%, respectively, for patients treated with tyrosine kinase inhibitors only (p = 0.050).DC immunotherapy is a safe treatment for transplant recipients with HCC recurrence. Adding DC-immunotherapy to the treatment regimen could prolong the survival of some patients.